Fraction Of Cancers Attributable To Tobacco Smoking In France

Bochen CAO, International Agency for Research on Cancer, France
BRAY F. 1 , ARWIDSON P. 2 , BONALDI C. 3 , MENVIELLE G. 4 , ROUX M. 1 , HILL C. 5 , SOERJOMATARAM I. 1

1 Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
2 Direction des affaires scientifiques, Institut national de prévention et d'éducation pour la santé, Saint Denis Cedex, France
3 Département de Maladies Chronique et Traumatismes (DMCT), Institut de Veille Sanitaire, St Maurice Cedex, France
4 Equipe de Recherche en Epidémiologie Sociale (ERES), Institut national de la santé et de la recherche médicale, Paris, France
5 Institut Gustave Roussy, Villejuif, France

Purpose: To estimate the population attributable fraction (PAF) and associated numbers of cases for various cancer sites in France in 2012 due to both active and domestic passive tobacco smoking.
Methods: We extracted age- and sex-specific population and national estimates of cancer incidence for France, and incidence rates of lung cancer among never-smokers and risk estimates for smoking and various cancers from the American Cancer Prevention Study (CPS II). For active smoking, we applied the Peto-Lopez method to estimate the PAF for lung cancer and applied the Levin’s formula to estimate the PAF for other sites. Using survey-based smoking prevalence in France and marital status data to calculate the proportion of non-smokers living with an ever-smoker partner. Using the relative risks for second-hand smoking we estimated the PAF for lung cancer due to domestic passive smoking.
Results: Among cancer sites included, 47,892 (52%) and 12,645 (26%) cancer cases for men and women between age 35 to 84 respectively in France in 2012 were attributable to tobacco smoking. Among males, tobacco smoking accounts for 23,693 lung (PAF 89%), 6,279 oral cavity & pharyngeal (82%), 3,405 bladder (42%), and 2,820 kidney (39%) cancer cases. Among females, it is responsible for 7,045 lung (68%), oral cavity & pharyngeal (49%), 773 colorectal (5%) and 767 ovarian (19%) cancer cases. Domestic passive smoking is responsible for 47 (4.5%) and 62 (2.8%) lung cancer cases among male and female never-smokers in France.
Conclusions: Tobacco smoking is responsible for over 40% of the cancer cases from major cancer sites. More effective tobacco control programmes are therefore essential to reduce the cancer burden in France.
Funding Sources: French National Cancer Institute